Abstract
A 63-year-old woman who underwent total gastrectomy with Roux-en-Y anastomosis because of gastric cancer was admitted because of obstructive jaundice. Lymph node recurrence was suspected. As shown in Video 1 (available online at www.giejournal.org), after puncturing the intrahepatic bile duct by using a 19gauge, FNA needle, we injected contrast medium. The lower bile duct was obstructed, and a guidewire was advanced into the common bile duct. Next, we inserted a dilator (SBDC-9; Soehendra Biliary Dilation Catheter, Cook Medical, Bloomington, Ind) to the site of bile duct obstruction. First, we inserted the biopsy device (Spy Bite Biopsy Forceps; Boston Scientific, Tokyo, Japan) through a dilator catheter and performed for-
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